The Do’s and Don’ts to Guide You Down the Path to
Part D Enrollment

As you journey down the road towards choosing a Medicare prescription drug plan, you’ll likely hit some bumps along the way. Below are some tips to help you navigate the roadblocks and enroll in a Part D plan that best meets your needs.

Keep these do’s and don’ts in mind while considering your Part D options:

Don’t delay. It takes time to research and find the plan that best meets your needs. Make sure to start that research early to make sure you have enough time to identify and consider your options. Be sure to enroll before December 7th to avoid paying late enrollment penalty fees.

Do check a plan’s formulary (the list of drugs the plan covers) to make sure that all the prescription medications you currently take are covered. Also talk to your doctor about drugs that you may be prescribed in the coming year, so you can make sure that those are also on the formulary.  While you can’t predict all your future prescription needs, it’s best to be well prepared for the ones that could be added to your treatment plan in the months ahead.

Don’t make your decision based solely on the plan’s monthly premium. The cost of the premium is only one factor to consider when determining the full cost of the plan. Deductibles and copayments also need to be considered, as well as the medications you take. If you regularly take only one or two prescription drugs, then a low premium plan may work well for you. However, if you take three or more medications, you may require more comprehensive coverage than a low premium plan offers. Remember to always evaluate the overall annual costs of the plan when making your selection.

Do opt for a plan with a preferred pharmacy network that includes your current retail pharmacy or another one that’s conveniently located. Preferred pharmacies offer lower copays for prescription drugs. If you’re on a medication that you take regularly for a chronic condition, you may be able to save even more money if there is a preferred mail delivery pharmacy option. It’s also easy and convenient to get your prescriptions delivered right to your home.

Don’t ignore Star Ratings. Plans are given between one and five stars by the Centers for Medicare & Medicaid Services (CMS) based on several factors including customer service and the quality of the care provided by the plan. Make sure to always check the plan’s Star Rating before you make your final decision.

Do seek out help in choosing a plan. Reading through each plan’s fine print and understanding what it all means is no easy task. Once you’ve done your research, take advantage of resources that are available to help guide you through the final decision-making process. Some of that help can be found right in your community. Your State Health Insurance Assistance Program (SHIP) provides a call line to answer Medicare questions. There are also Medicare insurance brokers that are available free of charge and can help you find the plan that meets your needs.

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Three Hazards to Avoid when Picking a Plan

There are avoidable hazards on road to picking the Medicare Part D plan that right for you. This video outlines the route to finding that plan by avoiding the three most common hazards.

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The Medicare Donut Hole is Closing Faster. What Does That Really Mean?

The Medicare Part D coverage gap—commonly referred to as the donut hole—scheduled to close in 2020 is now closing one year early for brand-name drugs. The coverage gap for generic drugs will stay on track to close in 2020.

Here’s what you need to know:

What’s changing in 2019?

In a standard Medicare Part D plan, the third stage of coverage is the Coverage Gap, when beneficiaries pay more for covered brand-name and generic medications.  In 2019, the portion a beneficiary pays for a drug in this stage will drop to 25% of the cost for their brand drugs (instead of 30%) and 37% of the cost for generics (instead of 44%).  

What does that really mean?

The accelerated closure of the gap for brand-name drugs may result in bigger savings for Medicare beneficiaries who have a prescription drug plan.

Is the Coverage Gap stage eliminated with the faster closing of the donut hole?

No, the Coverage Gap stage is not being eliminated.
By 2020, the gap will close and the cost-sharing amount for beneficiaries in this stage will be 25% for both brand and generic medications.

What do I need to know about the Coverage Gap stage?

Medicare Part D plans have four different stages that impact what you will pay for your prescription medications. These stages are called Deductible, Initial Coverage, Coverage Gap, and Catastrophic Coverage.

Go to this article to learn more about what each stage means and how they impact your prescription medication costs. You can also find great tips on ways to avoid the coverage gap here.

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Moving Your Plan When You’re on the Move

What you need to know about your coverage when you relocate

There are many things to think about when you’re moving, such as finding a new home or adjusting to a new neighborhood. Finding a new Medicare Part D plan might be overlooked. Whether you’re moving to a new state or a snowbird that migrates to a warmer climate during the colder months, it’s important to know how relocating can affect your Medicare Part D coverage.
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